How to Save a Life
by RoryGilmore08
Summary: How the events in the Season 11 episode should have gone.


How to Save a Life

An ambulance with sirens roaring pulls up to the trauma bay outside Dillard Medical Center, a small hospital on the edge of Seattle, a hospital that has already seen more trauma in the past hour than it is equipped for.

"No, no, no, wait. What, No! Another one?" A resident said coming outside to greet the ambulance. "No, no, no, no, no" He said as the paramedics began unloading Derek Shepard from the back of the ambulance. "We've already got that lady and her kids, the girl with the guts, and the dude with the head injury." He argued.

"When it rains, it pours." The paramedic told him unsympathetically.

"Okay, it needs to pour somewhere else, because we are not a trauma center." The resident argued. "We're not properly equipped for this sort of thing." He added as Derek was removed from the ambulance strapped to a gurney in a neck brace and an obvious laceration on his head, the paramedics began wheeling him inside ignoring the resident. "We don't have rooms. You guys know that." He protested.

"Make room." The paramedic shot back. "What are we supposed to do with the guy?" He said closing the ambulance doors. "Look at him."

The resident stares at Derek for a second and sighs. "All right, fine. This isn't on me." He says as Derek is rolled into the emergency room, eyes wide open and pupils moving taking in his surroundings, or what he can see of them.

"John Doe, broadsided by a semi-truck" The paramedic said officially handing the case off to the Dillard staff while walking into the emergency room. "Blunt-force trauma to the head, chest, and abdomen. Persistent hypotension after two liters of saline. Pulse is thready at 130." He said helping the team lift Derek from the gurney to a trauma bed.

" _You're not dead."_ Derek thought to himself. " _Just breathe."_

"I need four units of blood." Another resident, named Toby, said as they began examining him.

" _Scalp lac. Probably multiple fractures. Try to hold still."_ Derek told himself as Penny Blake walked into the room.

"John Doe. Bad MVA. Had to be extricated." Toby told Penny as she began a neurological exam on Derek. "Positive loss of consciousness at the scene. He's poorly responsive. GCS of 10."

"What's your name, Sir?" Penny asked Derek. "Can you hear me?"

" _Yes. Yes, I can hear you."_ Derek said to himself. _"Loss of verbal skills. Possible bleeding in the brain."_

"His pupils are equal and reactive." Penny said.

 _"Good sign. Still should get a C.T."_ Derek said.

"He's got a flail chest in the right. I need a 36 French tube now." Penny said to Toby. "Sir, can you tell me your name?" She asked Derek once again.

"He's still hypotensive and tachycardic. Up to two fluild boluses." Toby informed Penny.

"He could be bleeding in his chest." Penny said as a nurse put gloves on her. "Hang two units of blood on the infuser." Penny directed. "I need a trauma panel, and X-Ray and cross him for four. And can somebody page surgery again?" She said shouting the last request.

 _"She's smart. I like her."_ Derek said.

"I'm sorry." Penny said to Derek. "This is going to hurt, but we have to do it." Penny assured as she made a cut to insert the chest tube. When the tube went in Derek let out a large gasp. "That must have hurt. I'm sorry. Can you please tell me your name? She asked once more. "Can you tell me anything?"

In the emergency room, Winnie is watching the doctors take care of her mother and sees Alana get wheeled off, and Charlie getting his head stitched up and notices Derek in a bed near her mother once Penny opens the curtain to step out. "Mom, I'm going to the bathroom."

"Ask a nurse where it is." Her mom, Sarah, says and Winnie slowly walks towards Derek's bed.

"I'm ordering a head C.T. We don't know the extent of his head injury." A doctor said.

" _She's right. You don't."_ Derek said.

"Look at the ultrasound." Another doctor said. "He's bleeding into his belly. We don't have time for a C.T."

" _Arrogant."_ Derek said. _"Because she's younger than you. And probably because she's a woman."_

"I just think that -" The female doctor began but the male cut her off.

"We don't have time for a C.T." He asserted. "He needs to go straight to an O.R,!"

" _You have this. Come on. Don't back down."_ Derek said.

"I don't think we have a handle on-" The female doctor began but was cut off again.

"His GCS hasn't changed since he got here." The male doctor argued. "The C.T. can wait."

"C-Spine, chest, and pelvic films are up!" A tech called to the doctors.

While the doctors are looking at his films, Winnie opens the curtain and stands by his bed.

"Derek?" she says fearfully, trying not to cry.

" _Winnie, you shouldn't be in here."_ Derek said.

Winnie slowly reaches for Derek's wrist and tries to find a pulse. "You're not dead." She says holding back tears. "I know you're not dead. Know how I know? Cause I can feel your pulse, which means your heart is beating. Your heart is beating, which means you're not dead, okay." She says succumbing to the tears. "Hey, eyes on me. You stay not dead, okay? It's a beautiful day to save lives, right? So you stay not dead." Winnie says as a doctor comes back into the room.

"Hey, where are you supposed to be?" The male doctor from earlier asks.

"Is he gonna be alright?" Winnie asks.

"Whose kid is this?" The male doctor asks looking around the emergency room as Penny walks up next to him.

"I'll deal with it." Penny says pushing the male doctor aside as Winnie leaves Derek's side.

" _I'm not dead. I'm not dead."_ Derek repeats to himself.

"That man, do you know him?" Penny asked Winnie.

"Yeah, that's Derek." Winnie tells her.

"Derek? Derek who? Is he a family member? A neighbor?" Penny asked confused.

"He's my friend." Winnie responded.

"Okay." Penny said. "Do you know your friend's last name?"

"No, I mean, I just met him today. He pulled me and my mom out of our car after the accident. He fixed her leg, he helped Charlie, and he put Alana's insides back in. He saved us." Winnie explained.

"He saved you?" Penny asked shocked by the information the little girl had given.

"All of us." Winnie clarified. "He's a doctor."

"He's a doctor?" Penny repeated taken aback.

"A surgeon, I think." Winnie added.

" _My head, look at my head!"_ Derek repeated as monitors started beeping.

"Sedation please." The male doctor requested. "You need to calm down, buddy." He told Derek.

"He's a surgeon." Penny said opening the curtains around Derek.

"Let's get a…." The male doctor began and then froze as Penny's words sunk in.

"He's a surgeon, and he just saved everyone from the car accident that just came through." Penny informed.

"Doctor, we're going to sedate you now so we can secure your airway. You're going to be fine." The male doctor said lowering a mask to Derek's face.

" _No, I'm not."_ Derek argued. _"You need to wait."_ He said lifting a hand.

"Sux and etomidate in?" The male doctor asked.

"Yes." A nurse answered.

"It's okay." Penny said taking his hand. "We've got you. It's all gonna be okay."

" _This isn't right."_ Derek said. _You should've taken me to get a head C.T."_ Derek argued, as they began to move him towards the O.R,

"His pressure's holding. Maybe we should get the scan." Penny shouted as they ran down the hall.

" _Yes! Listen to her."_ Derek said.

"Too risky! He could bottom out in the scanner. We need to open him up and find the source of the bleeding." The male doctor argued.

"No, we don't we have the time!" Penny argued. "Brain before abdomen. He's stable."

" _Yes, yes. Listen to her!"_ Derek pleaded.

"Fine but this is on you." The male doctor shouted and they took him to C.T.

"Someone page neuro!" Penny shouted. "Tell him we have car against semi with a head lac."

"Cohn said he had a dinner tonight. Get to him soon." The male doctor said.

During the scan Penny and the male doctor were waiting for the results to show on the computer screen when a nurse comes in.

"Cohn says get him to an OR after the scan results he'll meet you there." A nurse says and then walks out.

"Thank you!" Penny called after him.

"Why were you so persistent on this C.T.?" The male doctor asked.

"He's moving. He's trying to talk to us. To communicate. Yes there's obvious blunt-force trauma everywhere on this man but loss of verbal skills when everything else was working. He can feel pain. He reacted when I inserted the chest tube. There's something going on." Penny explained.

"I hope your right." The male doctor said and the scans began to load on the computer. "Well I'll be damned. There it is. Good work, Blake."

"Not yet," Let's get him to Cohn and save this man's life." Penny said and they rushed him

Hours later Derek begins to wake up in a recovery room in the ICU to find Penny checking his vitals.

"Hey you're back!" Penny said. "Let me do a quick neuro exam." Penny said moving closer to him.

"You." Derek said.

"You can talk?" Penny said surprised.

"You saved me." Derek finished.

"Derek right? Can you tell me your last name?" Penny asked.

"Shepard." Derek responded and Penny's eyes got big.

"And what do you do for a living Mr. Shepard?"

"I'm a neurosurgeon. Currently at the NIH in Washington D.C. but moving back to Seattle to be with my wife and kids." Derek said. "Can someone call my wife?"

"Of course, Dr. Shepard. Right away." Penny said leaving the room.

"Blake, how's our patient doing?" Dr. Cohn asked standing at the nurse's station.

"Awake, responsive and talking. Dr. Cohn, we just operated on Derek Shepard."

"You're kidding me." Dr. Cohn said. "I just operated on the best neurosurgeon in the country? Thank god he's all right. Blake, good job sticking to your gut and getting that C.T."

"Thank you, Doctor." I need to track down his family.

An hour later Meredith arrives at Dillard Medical Center and askes the resident running the emergency room for help locating her husband.

"Hi, I'm Dr. Meredith Grey, I'm looking for my husband, Derek Shepard. He was brought in earlier.

"He's up in ICU, Hey Blake, This is Derek Shepard's wife, Dr. Grey, can you take her up to her husband?"

"Yes, of course," Penny said walking over to Meredith. "Right this way Dr, Grey." She said and led her to Derek.

"They said a semi hit him?" Meredith asked as she observed her surroundings, "Are you guys equipped to deal with that?"

"We manage." Penny said. Here's your husband's room Dr. Grey." She motioned and they walked in.

"What did you do?" Meredith said looking at Derek.

"Oh, I did what I always do, except I almost killed myself doing it." Derek said and noticed Penny behind her. "She saved me." He said looking at Penny. "They didn't want a head C.T. and she fought for one." He said and Meredith turned to her.

"Thank you." She said sincerely.

"I'm only doing my job." Penny said. "I'll leave you two alone.

"Dr. Blake, once I'm stable, I need to be transferred home to Grey Sloan." Derek said.

"Of course." Penny said and left the room.

"Remind me to talk to Richard about her. She's too talented to be in a place like this." Derek told Meredith.

"One thing at a time." Meredith said as there was a knock on the door. In the doorway were Winnie and her mom, Sarah.

"Derek, I'm sorry to bother you, but Winnie didn't want to leave until she saw you were okay." Sarah said.

"That's fine." Derek said. "Winnie, I'm doing just fine. Thank you for being such a great helper today.

"I'm just happy you're not dead. You saved all of us and derived to live." Winnie said.

"Who is all of us?" Meredith asked.

"He pulled me and my mom from the car, saved Charlie and put Alana's insides back in her." Winnie explained.

"Wow, you all had a very busy day." Meredith said.

"Okay, Winnie, it's time to go. Derek needs to rest." Sarah said.

"Bye, Derek."

"Bye, Winnie." He said and they left.

"You did have a very eventful day, didn't you?" Meredith said.

"It was a beautiful day to save lives." Derek said. "Even though I did in fact miss my flight and almost died." He said as Meredith climbed into bed with him and he fell asleep.


End file.
